Changes of interleukin-6, tumor necrosis factor-alpha, and total antioxidant ability in the umbilical venous plasma of preterm birth with or without premature rupture of membranes / 대한산부인과학회지

OBJECTIVE: To compare interleukin-6 (IL-6), tumor necrosis factor-alpha(TNF-alpha), oxygen-radical absorbance capacity (ORAC), and antioxidant vitamin levels in the umbilical venous plasma of preterm labor with intact membranes (PTL) and preterm premature rupture of membrane (PPROM) with that of full term normal pregnancy (NP) and to evaluate their roles of pathophysiology in preterm labor and PPROM. METHODS: Umbilical venous blood samples were collected from women with PTL (n=30), PPROM (n=30) and NP (n=30). IL-6 and TNF-alpha were measured by enzyme-linked immunosorbent assay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC was mesured by Cao's method. Antioxidant vitamin levels were measured by high performance liquid chromatography. RESULTS: IL-6 and TNF-alpha levels in the umbilical venous plasma of PPROM were significantly higher than that of PTL and NP (3.28+/-0.31 vs. 2.84+/-0.19 vs. 2.79+/-0.22 pg/ml, p<0.05), (2.30+/-0.27 vs. 1.64+/-0.23 vs. 1.40+/-0.25 pg/ml, p<0.01). Lipid peroxide levels in the umbilical venous plasma of PPROM were significantly higher than that of NP and PTL (2.78+/-0.27 vs. 2.54+/-0.32 vs. 2.24+/-0.24 nmol/mg protein, p<0.01). ORAC levels in the umbilical venous plasma of PTL and PPROM were significantly lower than that of NP (967425.4+/-98.99 vs. 965165.8+/-91.20 vs. 1011328.5+/-85.96 U/ml, p<0.05). Ascorbic acid levels in the umbilical venous plasma of PPROM were significantly lower than that of NP and PTL (125.6+/-2.33 vs. 158.3+/-3.08 vs. 221.7+/-2.82 nmol/ml, p<0.01). CONCLUSION: Increase in inflammatory cytokines (IL-6, TNF-alpha) and imbalance of increased lipid peroxidation and decreased antioxidant activity in umbilical venous blood may be involved in the pathophysiology of PPROM.

A Case of Fetal Congenital Mesoblastic Nephroma with Oligohydramnios

Although congenital renal tumors are rare, congenital mesoblastic nephroma (CMN) is the most common renal tumor in early infancy. It is non-metastatic, well differentiated, amenable to surgical removal, and carries a good prognosis. Polyhydramnios has been detected in most of the published cases of CMN. However, we experienced a rare case of fetal CMN associated with oligohydramnios. A 28-yr old woman at 34 weeks of gestation was referred to our hospital for oligohydramnios and a fetal abdominal mass. An ultrasonography revealed a huge, well-encapsulated mass arising from the right kidney. An emergency cesarean section was performed due to fetal distress. After birth, despite intensive neonatal care, the baby died because of renal failure, disseminated intravascular coagulopathy, pulmonary edema, together with other problems.

Clinical Review on 93 Cases of Laparoscopic Myomectomy / 대한산부인과학회잡지

OBJECTIVE: The study was undertaken to evaluate clinical safety and usefulness of laparoscopic myomectomy with analyzing clinical course and postoperative complications of 93 patients underwent laparoscopic myomectomy at Yosu Chon-nam Hospital and to introduce operative methods executed in this hospital. METHODS: Total number of patients underwent laparoscopic myomectomy at Yosu Chon-nam Hospital from May 2001 to December 2002 was 93. With ward chart and admission recordings, Age, parity, symtom, size of myoma, number of myoma, location operation time and hemoglobin change were recorded. Data were analyzed with Microsoft Excel. RESULTS: The mean age of patients was 42.68 ( +/- 6.05) years. The mean parity was 2.02 ( +/- 0.96). The mean number of myoma was 1.70 ( +/- 1.27). The mean weight of myoma was 71.7 ( +/- 56.4) gm. The most common symtom was hypermenorrhea. The location of myoma was submucosal, intramural, subserosal in large order. The mean operation time was 101.1 ( +/- 30.2) minutes. The mean hemoglobin change after operation was 1.40 ( +/- 0.81) g/dL. Mean hospital stay was 3.90 ( +/- 1.20) days. The operative complication was trocar site bleeding (2 cases), surgical emphysema (2 cases). In 2 cases, Laparoscopic procedure was converted to laparotomic method. CONCLUSION: Indication of operation was extended in almost all age (including reproductive age) and 93 Laparoscopic myomectomy was done safely and effectively without severe complications. However, to obtain more safety and usefulness of laparoscopic myomectomy, adequate laparoscopic instrument and expertized operative technic should be demanded. In near future, laparoscopic myomectomy will be more popular and effective by variable technical development and ordered discipline.

A case of abnormally exposed nodular shaped-bronchial vessel occurred massive hemorrhage during bronchoscopy / 결핵

A 43 years old woman with a previous history of healed tuberculosis presented with a recurrent hemoptysis. On a broncoscopy inspection, three nodular shaped mass-like lesions (0.5cm in diameter) were found on the right lower lobar bronchus. Massive hemoptysis occurred when the specimen were taken during bronchoscopy. The bleeding could not be controlled by non-surgical treatment. Consequently, she underwent a right lower lobectomy in order to control the bleeding. The patient died of respiratory failure 3 days later. A brochoscopic biopsy revealed an abnormal blood vessel just beneath the bronchial respiratory epithelium.

A case of abnormally exposed nodular shaped-bronchial vessel occurred massive hemorrhage during bronchoscopy / 결핵

A 43 years old woman with a previous history of healed tuberculosis presented with a recurrent hemoptysis. On a broncoscopy inspection, three nodular shaped mass-like lesions (0.5cm in diameter) were found on the right lower lobar bronchus. Massive hemoptysis occurred when the specimen were taken during bronchoscopy. The bleeding could not be controlled by non-surgical treatment. Consequently, she underwent a right lower lobectomy in order to control the bleeding. The patient died of respiratory failure 3 days later. A brochoscopic biopsy revealed an abnormal blood vessel just beneath the bronchial respiratory epithelium.